GABHS, Group A beta hemolytic streptococcus

Clinic

Group A β-hemolytic streptococcus can cause infections of the throat and skin. These may vary from very mild conditions to severe, life-threatening diseases due to host immune function stability.

Most common

Impetigo,

Cellulitis, and erysipelas and Necrotizing fasciitis

Pharyngitis: 15–30% of childhood cases and 10% of adults

Less common

Bacteremia Septic arthritis Osteomyelitis Vaginitis – vagina (more common in pre-pubescent girls) Meningitis Sinusitis Pneumonia* – pulmonary alveolus

(*Note that meningitis, sinusitis and pneumonia can all be caused by Group A Strep, but are much more commonly associated with Streptococcus pneumoniae and should not be confused.)

Severe infections:Shock, multisystem organ failure, and death.

Complications

Poststreptococcal glomerulonephritis

Streptococcal toxic shock syndrome (STSS)

Rheumatic fever

PANDAS

Rubrics

CHEST - HEART; complaints of the - endocarditis THROAT - INFLAMMATION - Tonsils THROAT - INFLAMMATION - Pharynx CHEST - INFLAMMATION - Lungs EAR - INFLAMMATION - Media CHEST - INFLAMMATION - Heart - Endocardium SKIN - ERUPTIONS - impetigo GENERALS - INFLAMMATION - cellulitis SKIN - ERYSIPELAS GENERALS - INFLAMMATION - Lymphatic vessels GENERALS - SEPTICEMIA, blood poisoning GENERALS - INFLAMMATION - Muscles; of HEAD - INFLAMMATION - Meninges

GENERALS - CHOREA FEMALE GENITALIA/SEX - INFLAMMATION - Uterus GENERALS - INFLAMMATION - Bones; of GENERALS - INFLAMMATION - Joints; of KIDNEYS - INFLAMMATION FEMALE GENITALIA/SEX - INFLAMMATION - Uterus - endometritis

Remedies ARS, MERC LACH, SUL, PHOS, KALI-I Bell, Nat-m, Tub Apis, Hep, Bry, Crot-h

Pharyngitis Throat, Pharyngitis Impetigo Skin, Impetigo Arthritis

Osteomyelitis

Ext, Inflamation, Periostitis Vaginitis Meningitis Sinusitis Pneumonia*

Arthritis

Phayngitis

Endocarditis

Meningitis

Osteomyelitis

Cellulitis

Special feature

GABHS Arthritis

GBS had now become the most common pathogen for bacterial septic arthritis (37.7%), while Staphylococcus aureus was the second most common causative pathogen (23.4%).

Unique clinical characteristics are

More number of joint involvements which were more likely (70%) to be oligo-polyarthritis. (Oligoarthritis is defined as arthritis affecting 2 to 4 joints during the first six months of disease.)The majority of patients in other bacterial septic arthritis in our study were affected in one joint as monoarthritis.

Knee is the most commonly affected joint in both groups.

Upper extremities and axial joint involvements were more common in GBS septic arthritis than other bacterial septic arthritis.

Tenosynovitis is extremely common in GBS septic arthritis (39.1%) which has seldomly presented before in other bacterial septic arthritis (2.1%).

CNS and ocular infections were commonly found in GBS septic arthritis more than other bacterial septic arthritis

GABHS Pharyngitis

Common signs and symptoms include

Sore throat

Temperature greater than 100.4°F (38°C)

Tonsillar exudates

Cervical adenopathy

Lymphangitis

Lymphangitis is inflammation of the lymphatic channels that occur as a result of infection at a site distal to the channel and may spread within hours. Group A beta-haemolytic streptococci are the most common causes of bacterial lymphangitis and, in severe cases, can lead to bacteraemia, sepsis and death Ref: Yamamoto LG. Treatment of skin and soft tissue infections. Pediatr Emerg Care 2017;33:49–55. Review doi:10.1097/PEC.0000000000001001

Related disease

Sydenham's chorea

PANDAS